- Arthur Caplan: Conrad Murray found guilty; will case have impact on celebrity medicine?
- He says likely not; celebrity docs a mix of the skilled and discreet and the incompetent
- But, he asks, will those who can afford exclusive care start to ponder whether it's smart move?
- Caplan: Medicine not done best when it lacks another opinion: Jackson case offers good proof.
Dr. Conrad Murray has been found guilty of involuntary manslaughter in the death of Michael Jackson. It hardly could have been otherwise. The mere fact that Murray used a highly dangerous and difficult to manage drug, propofol, to treat Jackson's insomnia showed that he was acting in an irresponsible way. Even highly trained anesthesiologists in hospitals know they have to be extra careful with that drug.
The trial resulted in Murray being held accountable. But the outcome also raised some important questions: What impact will the case have on the practice of celebrity medicine? And will celebrities learn anything about getting the kind of medical care that best serves their health?
Doctors and nurses who treat celebrities can be something of an odd lot. Some are skilled practitioners who enjoy the high pay and the good hours. Others, however, wind up in this kind of boutique practice because their medical colleagues do not think much of their skills.
The trial is unlikely to change these things very much: The competent docs and nurses will care for the rich and famous discreetly and within the boundaries of what they know how to do; the less principled, like Murray, will simply cater to their patient's whims, fail to treat disease but only handle the symptoms and extend what they try to do beyond the domain of their training.
Which raises a question for others who may find this exclusive relationship seductive: Is it really smart to hire your own personal doctor or nurse even if you can afford it? Sure if what they are doing is basically primary care or, if they have the appropriate experience and training in handling a special problem like diabetes or a mental illness.
But even then, it is still a good idea to let other doctors take a look at you once and awhile. Medicine is done best when more than one doctor takes a crack at diagnosis and prescription. Quality is best assured when someone is there to check and comment on what another doctor thinks best.
In the end medicine is really not done best -- either for the doctor or the patient -- when it is done solo. If you think otherwise you need only remind yourself of how far outside the realm of medical standards Conrad Murray managed to go with a patient who was more than willing to go there.